Guest guest Posted October 15, 2004 Report Share Posted October 15, 2004 I was verbally told by our HMO member services rep (phone) that I had 50% coverage for DME (Durable Medical Equip). I went ahead and made the appt'mt to get him measured and the helmet ordered. The orthotist then faxed in the request and 48 hrs later we received our 1st denial letter. The ped neurosurg called my HMO to verbally appeal it (even though he wasn't even pro-band) but they gave me a 2nd denial letter. So YES even though we received the denial , a few wks later we had our visit for Colin to be measured; we paid for and ordered the helmet and then received the helmet *before* I won the appeal. We were finally reimbursed 50% while we were about half-way into helmet therapy. However, we were prepared to just pay for it ourselves if we didn't get any ins. coverage. It was just something that we really felt we wanted to do. Sorry for the long-winded answer! Sue > > > > > > > > > > Hello, > > > > > > > > > > What was your child's standard Deviation? And did you end up > > > going > > > > > with a band? > > > > > > > > > > ALyssa is 3, can anyone translate that for me, hehe! > > > > > > > > > > Donna Quote Link to comment Share on other sites More sharing options...
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